Augmentin Suspension Dosing for Adults
For adults requiring Augmentin suspension, the standard dose is 500 mg amoxicillin/125 mg clavulanate three times daily or 875 mg/125 mg twice daily, with the 875 mg formulation preferred for respiratory tract infections. 1
Standard Adult Dosing Regimens
Mild-to-Moderate Infections
- 500 mg/125 mg three times daily is appropriate for most mild-to-moderate infections including urinary tract infections, skin infections, and uncomplicated respiratory infections 1, 2
- 875 mg/125 mg twice daily is the preferred regimen for respiratory tract infections including acute bacterial rhinosinusitis, community-acquired pneumonia, and acute exacerbations of chronic bronchitis 1, 2
High-Risk or Severe Respiratory Infections
- 2000 mg/125 mg twice daily (pharmacokinetically enhanced formulation) is recommended for adults with risk factors including recent antibiotic use within 4-6 weeks, treatment failure, moderate-to-severe illness, or areas with high prevalence (>10%) of penicillin-resistant Streptococcus pneumoniae 1, 3
Treatment Duration by Indication
- Acute bacterial rhinosinusitis: 5-7 days 1, 2
- Community-acquired pneumonia: 5-7 days if afebrile for 48 hours and clinically stable 2
- Streptococcal pharyngitis (when indicated for chronic carriers): 10 days to prevent acute rheumatic fever 2
- Animal or human bites: 5 days at 500 mg/125 mg twice daily 2
Critical Dosing Pitfalls to Avoid
- Never substitute two 250 mg tablets for one 500 mg tablet - this results in excessive clavulanate dosing (250 mg vs 125 mg) and significantly increases gastrointestinal side effects, particularly diarrhea 1, 2
- The clavulanate component is fixed at 125 mg per dose in standard adult formulations regardless of the amoxicillin content 1
- If no clinical improvement occurs after 72 hours, switch to a respiratory fluoroquinolone (levofloxacin or moxifloxacin) or escalate to high-dose amoxicillin/clavulanate if not already used 1, 3
Special Clinical Scenarios
Asplenic Patients (Emergency Standby)
- 3 g starting dose followed by 1 g every 8 hours for unexplained fever or constitutional symptoms 1
- For animal bites in asplenic patients: standard 5-day course 1
Lyme Disease with Cellulitis
- 500 mg three times daily for 14 days when covering both early Lyme disease and bacterial cellulitis 2
Administration Considerations
- Augmentin should be taken at the start of a meal to enhance absorption and minimize gastrointestinal side effects 4
- Peak serum levels of amoxicillin occur at 2 hours (11.23 µg/mL) and clavulanic acid at 1 hour (2.55 µg/mL) after oral administration 5
- The suspension formulation achieves adequate tissue penetration with peak sputum concentrations of 1.31 µg/mL for amoxicillin at 4 hours 5